垂体后叶素致腹泻、重度低血钠1例  

A case of diarrhea and severe hyponatremia caused by pituitrin

作　　者：王哲[1] 任远勤 舒鹤[1] 张莉[1] 张萍 霍焜[4] WANG Zhe;REN Yuan-qin;SHU He;ZHANG Li;ZHANG Ping;HUO Kun(Department of Pharmacy,General Hospital of Jinan Military Command,Jinan 250031,China;Department of Pharmacy,No.154 Hospital of PLA,Xinyang 464000,China;Department of Clinic,North Battlefield Army Staff Department,Jinan 250000,China;General Practice Department,General Hospital of Jinan Military Command,Jinan 250031,China)

机构地区：[1]济南军区总医院药剂科,山东济南250031 [2]解放军第一五四中心医院药械科,河南信阳464000 [3]北部战区陆军部参谋部门诊部,山东济南250000 [4]济南军区总医院医疗科,山东济南250031

出　　处：《中国药物应用与监测》2018年第2期128-130,共3页Chinese Journal of Drug Application and Monitoring

摘　　要：1例52岁女性患者,因"反复咳嗽、咳痰50余年,加重伴痰中带血2 d"入院。入院诊断为"慢性阻塞性肺疾病并感染,支气管扩张伴咯血"。入院后生化检查示血钠141 mmol·L^(-1),因患者日咯血量达20 mL,给予垂体后叶素12 U,泵内注射,qd,止血治疗。住院第9日晨起,患者突然出现恶心、呕吐的症状,呕吐物为胃内容物。经询问得知患者自使用垂体后叶素第2天起即出现腹泻症状,为水样稀便,每日5~6次,并不伴腹痛。急查血生化示血钠111.1 mol·L^(-1),处于严重低血钠水平。因治疗需要无法停用垂体后叶素,经减量使用垂体后叶素、缓慢补钠以及止泻、止呕等对症处理4 d后,复测血生化示血钠138.9 mmol·L^(-1),血钠水平恢复正常。后续治疗中患者未再出现呕吐、腹泻、咯血症状,经治疗14 d,患者病情平稳,予以出院。A 52-year-old woman was hospitalized mainly because of repeated cough and expectoration over 50 years,aggravation with blood in phlegm for 2 days.The admission diagnosis was chronic obstructive pulmonary disease and infection,bronchiectasis with hemoptysis.The blood biochemical examination results showed the serum sodium was 141.1 mol·L-1.The hemoptysis volumn was 20 mL per day,so pituitrin was used to stop bleeding.On the 9th day,the patient developed nausea and vomitting.The vomit was stomach contents.After inquiry,clinical pharmacists learned that the patient developed diarrhea without abdominal pain,water stool,5– 6 times per day on day 2 after using pituitrin.Blood biochemical test showed that the serum sodium was 111.1 mol·L-1,wihich could be considered as severe hyponatremia.And then the dose of pituitrin was decreased.Symptomatic treatement including slow sodium supplementation,antidiarrheal,antiemetic and so on was given to the patient simultaneously.Four days later,the blood sodium rose to 138.9 mmol·L-1.After 14 days of treatment,the patient was discharged with a stable condition.

关 键 词：垂体后叶素 腹泻 低血钠症 药品不良反应 

分 类 号：R969.3[医药卫生—药理学]